Inspection on 28/01/06 for Jessie Place

This inspection was carried out on 28th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jessie Place 26/11/07

Jessie Place 29/06/06

Jessie Place 22/06/05

Jessie Place 04/10/04

Jessie Place 05/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Jessie Place 39 Stanthorpe Road Streatham London SW16 2DZ Lead Inspector Lynne Field Unannounced Inspection 28th January 2006 09:00 Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Jessie Place Address 39 Stanthorpe Road Streatham London SW16 2DZ 0208-769-3591 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Jane`s House Limited Mr Raja Manikam Paramal Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: Jessie Place is a large semi-detached house in a residential area. It is within a few minutes walking distance from a main shopping area, which has full community facilities and public transport links. It is a privately owned home, registered since November 1999, which provides long-term residential care for people with mental health problems. The home is registered for 6 service users, who are accommodated in six single bedrooms, one with an en-suite bathroom. There are three communal areas, one of which is a large conservatory with steps leading down to a large landscaped back garden and there is a front garden area that has been converted for parking use. The staff team is small, but fairly stable and experienced with this service user group. The home is not designed to cater for people with physical disabilities, although wheelchair users would have access to the ground floor, which has one bedroom, a toilet and all the communal areas. The home aims to encourage service users to take part in daily activities and to reach their optimum level of functioning, with current service users attending a variety of regular daily activities outside the home. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours on 28th January 2006. During the visit the inspector spoke with the registered manager and one of the care staff. A range of documents was examined and a tour of the building took place. The inspector met and spent time with four service users, who were able to express some of their views on the service provided at the home. The registered manager needs to be working at the home for the number of hours required to meet the registration requirements. The interaction between the service users and the staff on duty and the support that staff provided with some activities was observed. Most of the standards were inspected at the previous inspection were met and were not inspected again during this inspection. What the service does well: What has improved since the last inspection? What they could do better: Staff training and the recording of this could be more detailed and consistent. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 6 The home needs to draw up an action plan to address the lack of bathing facilities to bring it in line with the regulations and send a copy of this to CSCI. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 The Statement of Purpose and Service Users Guide contains the required information service users need to help them make a decision about coming to live at the home. Prospective service users’ needs and aspirations are assessed, so that a service tailored to their needs could be provided. EVIDENCE: The Statement of Purpose and Service Users Guide used by the home was reviewed and brought up to date at the time of the last inspection. All the service users have lived at the home for several years and there have been no recent admissions. All the files seen by the inspector had appropriate referral and assessment information in place. The homes policies and procedures state that prospective service users would always be invited for trial visits before moving in. The registered manager explained that this would usually be for a weekend or two days during the week. New service users would have a three-month trial period, which would be reviewed at a meeting involving the care manager, service user, service users family and the home before a placement is made permanent. Family and friends of prospective service users would be encouraged to visit the home at the same time. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 9 Contracts were seen by the inspector in the service user’s files and were signed by the registered manager and service user where appropriate. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Service users have individual care plans, and are involved in making decisions about their lives. Service users, relevant care professionals and their family are consulted in planning and reviewing care. Risk assessments are in place, are reviewed when appropriate. EVIDENCE: Five service user care plans were inspected during the course of the inspection. They included more information and detail in them about the likes, dislikes and needs of the service users that would assist the staff support the service users in the way they wanted to be assisted. The service users are involved in reviewing the care plans with the key worker and the registered manager and the service user have signed care plans where appropriate. One service user has challenging behaviour around her eating habits and although this is being managed by consulting with all the appropriate professionals and this is documented, there appears to be very little guidance or training for the staff on the day to day management of this behaviour. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 11 The home has risk assessments in place for all service users. The inspector was told by the registered manager that these are reviewed either annually or when there has been a change in the service users life. Service user reviews have been taking place annually and all the relevant people who are involved with the service user are invited to attend and the written actions agreed are on file. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15 Service users are encouraged to develop independent skills and interests as well as access the community with the support of staff when required. EVIDENCE: One service user told the inspector they were encouraged to help in the home. The inspector noted that one service user was setting the table for lunch. Staff told the inspector they encouraged service users to help in the home because it gave them an opportunity to develop their daily living skills. This included helping to prepare vegetables for the meal and doing their laundry with the support of staff. The home has an activities co-ordinator who supports service users to attend local activities such as going to the Library or leisure facilities at the leisure centre. Service users attend the local day services and the local church which they said they enjoyed going to. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 13 One service user visits their mother at the weekend and another service users mother visits regularly as well as them going home for visits. Service users again confirmed to the inspector that they were supported to maintain contact with family and friends and showed photographs and letters to the Inspector. In the past one service user had told the Inspector her brother comes to visit and likes the home and staff. Service users are able to come and go at the home freely and have keys to the front door as well as their own bedrooms. Records of meals are kept in the kitchen. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 The homes care planning and records have improved since the previous inspection and there is more information available for staff to be able to meet the needs of the service user in a way they like. Medication is being handled safely. Ageing, illness and ascertaining the service users’ wishes in the event of the death is being handled with sensitivity and respect by the registered manager. EVIDENCE: As previously stated some of the service users require prompting to complete their personal care. The inspector observed interaction between staff and service users, which was respectful and appropriate. Each service user is registered with the GP of their choice and Community Psychiatric Nurses visit regularly to work with the service users and support the staff. There is evidence on files of health care checks that have been undertaken and the recording of these has improved since the previous inspection. The inspector noted there was more detail and information of the out come of appointments on file. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 15 Service user medication is stored securely in a locked medication cabinet in the staff office. The inspector inspected three-service users medication at random. All medication stocks checked where in order. There were records on file signed by the service user saying they are unable to administer their own medication. This has been confirmed by the registered manager risk assessing this. The inspector noted in the service user’s files, there was a written agreement about the service users final wishes, that has been signed by the service user and/or their relative where appropriate. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home must review how it keeps and records all service users financial transactions to ensure service users are protected from possible financial abuse. There are safeguards in place to protect the service user from abuse, neglect and self-harm. EVIDENCE: There is a complaints policy and the inspector saw the complaints book. There was one complaint from a neighbour about the noise from a service users television. The registered manager spoke to both the neighbour and the service user and the issue has been resolved to everyone’s satisfaction. As part of the inspection the service users money and petty cash accounts were check and were in order. The registered manager explained the staff had had some training in recording the service users’ money. A receipt must be obtained for all purchases and the amount spent recorded in the service users’ accounts book. The member of staff supporting the service user when the money is spent signs this. This was a requirement from the previous inspection that has been met. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,30 The standard of décor within the home is good providing the service users with a homely place to live. There has been continued to be no change in the bathing facilities, which are not adequate for the five service users to share. The provider must consider installing en-suits facilities to meet the service users individual needs. The stair carpet needs to be replaced to ensure health and safety requirements are met. EVIDENCE: Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 18 The home is a three-storey building. It is comfortable and homely and was clean and tidy on the day of the inspection. There is a large garden at the back of the house. The home is fairly well maintained but some areas such as the bathroom and stairs are now shabby. Some of the stair carpet is worn in places and should be replaced. All service users have single bedrooms with one bedroom being en suite. Service users showed the inspector their bedrooms and they were furnished adequately and service users had individualised them with personal items. There is one bathroom and a separate toilet on the first floor and a toilet on the ground floor. Five people share the bathroom, which does not meet the national minimum standards. The registered provider has told the inspector at past inspections they were considering the viability of installing en-suites in other service user bedrooms. Although the action plan sent to the CSCI after the last inspection stating, “A review will be carried out to provide sufficient numbers of lavatories, bath and showers” there was no evidence this has been done. There is a large comfortable lounge, which leads into a small conservatory, which is used as a smoking room. The kitchen has a large dining area that has a large table where the service users eat their meals. A small paved patio and garden with grass and borders is to the rear of the home. The home provides care for people who have problems with their mental health but are ambulant so there are no adaptations or disability equipment in the home. The laundry facilities are located out side in a shed set up for this purpose and well away from where food is prepared and eaten. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35 The home is not providing the staff with refresher mandatory training or the range of training courses relevant to the care that they provide for the service users who live at the home. Staff training is not being fully documented on their personal files. EVIDENCE: The inspector was shown staff files by the registered manager. Records of staff training were poor and showed that they had a limited range of training. Two staff have completed NVQ level 3 and one member of staff has completed NVQ level 2. The home does not have a clear staff training and development programme to enable staff have their training needs met. Mandatory training has not been up dated in the last year. The registered manager must assessment of the skills / deficits of the whole staff team. This will ensure that staff are able to meet the needs of service users. A requirement was made at the previous inspection for staff to have training related to the service user group living at the home. This has been reinstated. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 There needs to be a clear, accurate and up-to-date rota of staff held at the home at all times, that includes the hours worked by the manager. Service users know the home is well managed and planned. The health, safety and welfare of service users is promoted and protected. EVIDENCE: On the day of the inspection there was not a current rota on display. The registered manager said he had not had time to write out the current weeks rota for staff. The inspector checked the previous rota, which was confusing to read. The registered manager does not appear to be supernumerary and works inconsistent hours. The registered manager needs to demonstrate he is working the required hours to meet the registration requirements of the home. The inspector spoke to three service users who said they liked living in the home. The inspector observed staff working with service users and noted that Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 21 service users and staff treated each other with respect and listened to each other. The registered manager told the inspector the home had sent out audit forms to the service users family. One mother said “her son was well cared for and was happy with his care ”. Another family said “the staff were very friendly and looked after her brother extremely well”. An audit form was sent to the GP, but there had been no response so far. All families who responded said they were aware of the complaints policy and would use it if they needed to. As part of the inspection the service users money and petty cash accounts were check and were in order. The registered manager explained the staff had had some training in recording the service users’ money. A receipt must be obtained for all purchases and the amount spent recorded in the service users’ accounts book. The member of staff supporting the service user when the money is spent signs this. This was a requirement from the previous inspection that has been met. Records indicated that all fire and electrical systems and equipment in the home are serviced and inspected appropriately and that all internal checks are conducted at appropriate intervals. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 2 3 x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jessie Place Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 2 X 3 X X 3 x DS0000022737.V266239.R01.S.doc Version 5.0 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA24 YA27 Regulation 13 (4) (a) 16 (2) (c) Requirement Timescale for action 31/05/06 3 YA32YA35 4 YA37 The registered person must replace the worn area of the stair carpet. 23(2)(J) The registered person must 30/04/06 review how the home can provide sufficient numbers of lavatories, baths and showers with the view to meeting the minimum standards with regard to the number and needs of the service users. Previous timescale of 15/01/06 not met. 18(1)(c)(i) The registered person must 31/05/06 ensure staff working in the home has training appropriate to the work they perform. Previous timescale of 15/01/06 not met. 17(2) Sch The registered person must 30/04/06 4(7) ensure that a clear, accurate and up-to-date rota of staff is held at the home at all times, that includes the hours worked by the registered manager. Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Jessie Place DS0000022737.V266239.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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